结膜刮削扫描电镜:培养阴性诊断感染性角膜炎的经验

IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL Reports (MDPI) Pub Date : 2023-02-27 DOI:10.3390/reports6010010
M. Troisi, Salvatore Del Prete, Salvatore Troisi, Daniela Marasco, C. Costagliola
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引用次数: 1

摘要

对65例连续的假定为微生物性角膜炎的患者进行评估,并对通过角膜刮除术获得的细菌和真菌培养测试呈阴性。所有患者均接受了局部广谱抗生素治疗至少5天,临床无任何改善。冲洗48–72小时后,刮除睑板上结膜,用扫描电子显微镜(SEM)对细胞形态进行细胞学检查。用这种方法在其中62名患者中检测到病原微生物的存在,并对其进行了特异性治疗。在10至49天的时间内,在所有阳性患者中观察到先前通过SEM检查检测到的微生物的临床改善和根除。在三名患者中,没有检测到微生物,但存在炎症细胞(嗜酸性粒细胞和肥大细胞)或干眼症。该方法可用于在普通培养试验中检测非分离微生物的存在。在随后的扫描电子显微镜细胞形态学细胞学检查中,感染性角膜炎的解决和病原体的根除支持了所提出方法的有效性。
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Scanning Electron Microscopy of Conjunctival Scraping: Our Experience in the Diagnosis of Infectious Keratitis with Negative Culture Tests
65 consecutive patients with presumed microbial keratitis and negative culture tests for bacteria and fungi obtained by corneal curettage were evaluated. All patients had undergone local broad spectrum antibiotic therapy for at least 5 days with no clinical improvement. After 48–72 h of wash-out they underwent scraping of the superior tarsal conjunctiva for cytological examination of cellular morphology in Scanning Electron Microscopy (SEM). The presence of pathogenic microorganisms was detected with this method in 62 of these patients, towards which specific therapy was carried out. Clinical improvement and eradication of microorganisms previously detected by SEM examination were observed in all positive patients over a time between 10 and 49 days. In three patients, no microorganisms were detected, but the presence of inflammatory cells (eosinophils and mast cells) or dry eye findings. This method could be useful to detect the presence of non-isolated microorganisms at common culture tests. The resolution of the infectious keratitis and the eradication of the pathogens at the subsequent cytological examination of cellular morphology in Scanning Electron Microscopy support the validity of the proposed method.
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